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Voice of the Editor
Professor Colleen E. Clancy, Editor-in-Chief of The Journal of Precision Medicine: Health and Disease
“New sensors and continuous monitoring tools now allow thermal mechanisms to be studied in individuals with unprecedented resolution. Wearable temperature patches, skin conductance sensors, and photoplethysmography can capture dynamic responses during exercise, sauna therapy, or heat exposure. Such data have the potential to be combined with molecular profiling and imaging to comprise a multidimensional personalised signature of thermoregulation.”
Professor Colleen E. Clancy
A woman walks into the forest on a winter morning. The air bites at her skin as she wades into a pool carved from glacial runoff. Her breath catches, her vessels constrict, and within seconds, her physiology responds and reconfigures to ensure short term survival. Was this scene set a millennium ago in Norway, or today in the California Sierra Nevada mountains?
Humans have long utilised temperature as therapy. The Edwin Smith Papyrus of ancient Egypt (ca. 3500 BCE) describes cooling inflamed wounds. Hippocrates prescribed cold-water immersion for vitality, while Roman bathhouses included the frigidarium for restoration. In Finland, avantouinti, or winter swimming, is both ritual and medicine. Across centuries, the principle endures: the controlled use of heat and cold to promote health, healing and resilience. It should not be forgotten that the history of thermal research also carries a sinister legacy: during World War II, Nazi physicians conducted the Dachau hypothermia experiments, in which prisoners were subjected to lethal cold in the name of “science”. The pursuit of physiological knowledge must always be bound by ethics and humanity.
Now, digital and analytical tools are transforming the ancient practice of thermal medicine into a new frontier of precision medicine. Thermal physiology reveals how the body responds to environmental challenge, and precision medicine provides the framework to understand these responses at the individual level. As precision medicine aims to understand how biological variability shapes health and disease, thermal stress provides a compelling natural or applied experiment in variability. When the human body is heated or cooled, it activates coordinated responses involving the vasculature, immune system, metabolism, and nervous system. These responses differ across individuals because of genetics, epigenetics, environment, and lifestyle.
New sensors and continuous monitoring tools now allow thermal mechanisms to be studied in individuals with unprecedented resolution. Wearable temperature patches, skin conductance sensors, and photoplethysmography can capture dynamic responses during exercise, sauna therapy, or heat exposure. Such data have the potential to be combined with molecular profiling and imaging to comprise a multidimensional personalised signature of thermoregulation. The complex data streams arising from such technologies can now be analysed with rapidly evolving artificial intelligence methods to identify patterns that cannot be revealed by traditional approaches. Machine learning models can then link subtle thermal signatures to disease risk, recovery potential, or resilience under stress. The resulting insights have strong potential to evolve thermal physiology from descriptive science to predictive medicine. For example, thermal therapies can be used to mimic some of the benefits of exercise and to improve metabolic and cardiovascular health. Repeated mild heat exposure has been shown to enhance endothelial function, increase insulin sensitivity, and reduce blood pressure in people unable to exercise regularly. Cold exposure, on the other hand, can improve mitochondrial efficiency and modulate immune tone.
Precision medicine includes evolving frameworks to incorporate thermal therapeutic measurements for personalised data-driven interventions. Thermal dose, which is defined by temperature, duration, and frequency, has the potential to be personalised using feedback from wearables and physiological monitoring. Continuous core temperature and heart rate sensors may allow for adaptive control of sauna, immersion, or localised thermal devices in real time. Artificial intelligence (AI) driven modeling can predict the physiological impact of different heating or cooling protocols before treatment begins, minimising risk and maximising benefit. By comparing individual digital profiles with population reference data, scientists and clinicians can calibrate the intensity of exposure like medication titration.
As global temperatures continue to rise, thermal physiology is a fundamental component of climate impact on health and disease. Heat exposure affects billions of people each year and contributes to cardiovascular, renal, and neurological morbidity. The recent Global Climate and Health Summit underscored that climate change is the most profound health challenge of our time and that solutions must connect science, policy, and lived experience. Thermal physiology shows how deeply connected the body is to the environment. The same regulatory systems that stabilise internal temperature are challenged by a warming climate. Precision medicine and artificial intelligence offer a unifying framework for studying and managing this relationship.
Wearables and smart textiles that measure temperature, hydration status, and cardiovascular strain can help identify early signs of heat stress. AI models that incorporate meteorological and physiological data can forecast individual risk and trigger targeted warnings for vulnerable groups. At the population level, integrating genomic and environmental data can reveal who is most susceptible to heat illness. For example, those with metabolic impairment, impaired sweating, or medications that affect thermoregulation. These models can also integrate genomic, metabolic, and environmental inputs, allowing personalised prediction and prevention. Such information can guide preventive strategies, from clinical counselling to urban design, linking precision health with planetary protection. Beyond clinical care, evolving tools can inform policy decisions about labour safety, housing, and urban heat management.
Thermal physiology embodies the systems principle of precision medicine: health emerges from the interaction of genes, cells, organs, behaviour, and environment. The future lies in combining wearable sensors, real time analytics, and AI driven modelling to create adaptive feedback systems for both therapy and prevention. Yet the access to such technologies is limited to those with economic and digital means, and their application has the potential to improve management of climate related effects exclusively in well-resourced communities. Such management may allow worsening of climate related health for those most affected and in need. Ethics require a deliberate global effort to ensure broader and more equitable access to the most under resourced communities that are disproportionately affected by climate change. To restate from above: the pursuit of physiological knowledge must always be bound by ethics and humanity.
Find out more about The Journal of Precision Medicine: Health and Disease and the journal’s latest call for papers.
